Abiomed Impella RP Manual Del Usuario página 17

INSERTING THE IMPELLA RP
NOTE – Proper surgical procedures and techniques are the responsibility of the
medical professional. The described procedure is furnished for information purposes
only. Each physician must evaluate the appropriateness of the procedure based on
his or her medical training and experience, the type of procedure, and the type of
systems used.
Fluoroscopy is required to guide placement of the Impella RP
placement guidewire must be reliably observed at all times.
Avoid manual compression of the inlet, outlet, or sensor areas of the cannula
assembly.
Do NOT kink or clamp any part of the Impella RP
Handle with care. The Impella RP
packaging, preparation, insertion, and removal. Do NOT bend, pull, or place excess
pressure on the catheter or mechanical components at any time.
IMPELLA RP INSERTION STEP-BY-STEP (23 FR PEEL-AWAY)
®
1. Confirm purge fluid is exiting the Impella Catheter.
2. Obtain access to the femoral vein.
3. Insert a 5–8 Fr introducer over the 0.035 inch guidewire (provided) to pre-dilate the vessel.
4. Remove the 5–8 Fr introducer over the 0.035 inch guidewire. Insert the 8 Fr, 12 Fr,
16 Fr, and 20 Fr dilators sequentially, as needed. Remove the 20 Fr dilator and insert the
23 Fr introducer with dilator. While inserting the 23 Fr introducer, hold the shaft of the
introducer to advance it into the vein.
5. Administer heparin. When ACT is at least 250 seconds, remove the 23 Fr dilator.
6. Insert a PA catheter or central-lumen flow catheter into the 23 Fr introducer and advance it
over a guidewire into the left (preferred) or right pulmonary artery.
7. Remove the 0.035 inch diagnostic guidewire, leaving the diagnostic or balloon-tipped
catheter in the pulmonary artery. Form a curve or bend on the 0.027 inch, 260 cm
placement guidewire and then insert it.
8. Advance the placement guidewire into the pulmonary artery, avoiding overinsertion to the
most distal pulmonary artery.
9. Remove the diagnostic or balloon-tipped catheter.
10. Wet the cannula with sterile water and backload the catheter onto the placement
guidewire. One or two people can load the catheter on the guidewire.
Impella RP ® with the Automated Impella
CATHETER
®
Catheter.
®
® Catheter can be damaged during removal from
® Controller
Catheter. The small
®
Shaded Steps
All shaded steps require
sterile technique.
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